Rheumatoid arthritis and gout are two different types of arthritis. They may have some symptoms in common, but they have different causes and require different treatment plans.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joints to become inflamed, stiff, painful, and swollen.
If left untreated, it can cause permanent damage that can interfere with your quality of life. According to the American College of Rheumatology, around 1.3 million Americans have RA.
RA is also a systemic disease. This means it can affect other organs of the body such as eyes, skin, lungs, and heart. People who have RA are at higher risk of heart disease than those who don’t.
Gout is an intensely painful type of arthritis that typically affects the big toe joint of the foot. It can also attack the top of the foot and ankle. Occasionally, it’s been known to attack other joints in the body.
The Greek philosopher-physician Hippocrates called gout the “arthritis of the rich” because it was historically associated with indulging in rich food and drink.
Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life.
However, a close look at initial signs and which joints are involved will clearly differentiate these two diseases. The best way to know whether you have RA or gout is to make an appointment with your doctor for a diagnosis.
Specific signs that distinguish the diseases:
- pain can be mild, moderate or severe and is typically associated with stiffness
- can affect any joint and is usually symmetrical on either side of the body
- most commonly occurs in the small joints of the hands, wrists, and feet
- joints may become painful, red, and swollen
- usually occurs in the foot, most commonly at the base of the big toe
- redness, swelling, and intense pain
The medical community doesn’t yet know what causes RA. Scientists think part of it has to do with a person’s genetic makeup and that the condition is triggered by something in the environment, like a virus.
Rich food and drink can cause gout indirectly. But the root cause is purines. These chemical compounds are found in certain foods.
Purine-rich foods include most meats (especially organ meats), most fish and shellfish, and even some vegetables. Whole-grain breads and cereals contain purines too.
The body converts purines into uric acid. Gout can occur whenever there is too much uric acid in the blood. Uric acid is normally expelled in the urine, but high levels can form sharp crystals in the joints, causing inflammation and intense pain.
RA can’t be cured. Treatment focuses on controlling joint inflammation, easing symptoms, and reducing damage to the joints. Your doctor will work with you to create a treatment plan that matches your needs.
Active, severe RA is usually treated with disease-modifying antirheumatic drugs (DMARDs) or powerful biologics. The latter are genetically engineered compounds designed to attack certain cells or chemicals that are involved in the immune process. They work to slow or stop the progression of the disease and can relieve inflammation and pain.
Mild-to-moderate RA is treated with nonbiologic DMARDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also used to treat pain and inflammation, often in addition to DMARDs.
In addition to medications, your doctor may recommend dietary changes.
Drugs that treat gout include:
- NSAIDs, such as indomethacin or naproxen (Naprelan, Naprosyn)
- corticosteroids, such as prednisone (Rayos)
- colchicine (Colcrys), given with NSAIDs to treat acute attacks or prevent future attacks
- medications that block the production of uric acid crystals
While RA and gout both cause pain and swelling of joints and can interfere with your daily activities, they have different causes and require different treatments. To tell which one you have, you’ll need to see your doctor for a diagnosis.
The symptoms from both conditions can generally be managed with a combination of medical treatments and healthy lifestyle changes. Talk to your doctor about which options best fit your situation.